| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
366 |
364 |
$23K |
| 92015 |
Determination of refractive state |
674 |
657 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
850 |
832 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
64 |
60 |
$5K |
| V2025 |
Deluxe frame |
30 |
29 |
$1K |
| V2756 |
Eye glass case |
281 |
277 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
35 |
28 |
$728.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
20 |
16 |
$92.00 |